Inspection on 20/05/08 for Deanbrook

This inspection was carried out on 20th May 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Deanbrook 09/05/06

Deanbrook 02/02/06

Deanbrook 23/06/05

Deanbrook 22/10/04

Deanbrook 13/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Deanbrook Totnes Road South Brent Devon TQ10 9BY Lead Inspector Wendy Baines Unannounced Inspection 20th May 2008 09:00 Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Deanbrook Address Totnes Road South Brent Devon TQ10 9BY 01364 72446 01364 72446 deanbrook@havencare.plus.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Havencare (Plymouth) Mrs Elizabeth Frances Grills Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 6 service users who have a learning disability and are aged over 18 years may be accommodated at any one time Adults with a learning disability who may also have a physical disability may be accommodated Date of last inspection Brief Description of the Service: Deanbrook is a large converted bungalow close to the centre of the village of South Brent. The home is owned by Havencare, (Plymouth) a voluntary organisation specialising in caring for adults with a Learning Disability. Deanbrook is registered to provide care for six people with a learning disability who may also have a physical disability, including those aged over 65 years. The home caters for people with a high level of needs. All bedrooms are single occupancy with en-suite facilities. There is a large communal lounge, separate dining room and large conservatory, which open onto extensive gardens. The property is all on one level with specialist bathing and toilet facilities for service users with a physical disability. Deanbrook has its own transport, which is used extensively and has access to the shops and facilities within the village. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is three star: This means the people who use this service experience excellent quality outcomes. This report is a summary of a cycle of Inspection activity at Deanbrook since the last inspection visit. To help CSCI make decisions about the home the Provider gave us information in writing about how the home is run; any documents submitted since the last inspection were examined along with the records of what was found at the last visit; A site visit totaling 7 hours was carried out with no prior notice being given to the home as to the date and timing; discussions were held with the Registered manager and staff on duty; various records were sampled, such as care plans and risk assessments; surveys were sent to a sample of staff ; and a tour was made of the home and garden; time was spent with the people who use the service and the inspector was able to talk with, and observe the staff on duty. A sample group of residents were selected and their experience of care was tracked through records and discussions with staff and management from the early days of their admission to the current date, looking at how well the home understands their needs and the opportunities and lifestyles they experience. Where possible time was then spent with these people, and feedback was sought from their care managers, health professionals and family. This inspection approach hopes to gather as much information about what the experience of living at the home is really like, and to make sure that service users views of the home forms the basis of this report. What the service does well: Deanbrook provides excellent individualised care and support for the people who live there. Good information is provided to prospective residents and their representatives to enable them to make an informed choice about where they live. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 6 Feedback from a relative and a health professional praised the home about how well they had supported one new resident when they recently moved into the home. The home undertakes a thorough and detailed assessment of each residents needs. This information is clearly documented so that staff can provide care in a consistent manner. A variety of different and creative methods are used to help people who use the service contribute and make choices about there care and lifestyle. There is a small and consistent staff team who have a good understanding of residents needs and are able to use this knowledge to encourage choice and independence. The home regularly liaises with the Primary health care and specialist Learning Disability services. Feedback from a health professional included; ‘ I am always very impressed, the staff have a good knowledge of the residents needs even if they haven’t been directly involved with them- their recording is excellent- they seem to know what information is important- Staff have a good knowledge of Dementia care and have provided excellent support to a resident during a recent admission to hospital’ The accommodation is comfortable and attractive and the provider continues to consider ways of improving the facilities to meet changing needs, What has improved since the last inspection? Since the last visit the home has been extended creating one new bedroom with en-suit facility. Changes have also been made to three of the original bedrooms. One room, which had previously been used for two residents’, has now been refurbished to create a single room with walk in shower. The staff office has moved into one of the smaller bedrooms, and this room has now been used to create a bedroom with improved facilities and space for a resident who has recently moved into the home. All bedrooms are now single occupancy, providing better space and privacy for all residents using the service. A wash hand basin has been fitted in the laundry room to improve hygiene in this area of the home. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 7 The home has purchased a wide screen television to improve the viewing for residents using the main communal sitting room. The Registered Manager has completed the Registered Managers Award. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. 1,2,3,4. This judgement has been made using available evidence including a visit to this service. People who may use the service and their representatives are provided with the information needed to choose a home that will meet their needs. People can be confident that the home will undertake a thorough admissions process so that everyone involved can make a decision about whether or not the individuals’ needs can be met. EVIDENCE: The home provides all new residents and their families with information about the environment and services provided. This is made available in different formats for people who may not be able to read or understand the written word. Since the last visit one new resident has moved into the home and their admission was discussed in detail to establish the quality of the homes admissions procedure and the experience of all those concerned. Records and discussion with family and other agencies confirmed that the home undertakes a thorough and detailed admissions process. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 10 Prior to admission the staff and managers at Deanbrook meet with the prospective resident and gather as much information about them as possible to ensure that they can adequately meet their needs. The individual and their families are invited to visit Deanbrook so that they can see their room and meet the staff and other residents. During this time the home puts together an initial ‘ care plan’ and ‘ Communication passport’, which provides details of the individuals needs and how they like to be supported. The inspector was able to speak to the family of one resident who had recently moved into the home and they said, ‘ We were made to feel very welcome, the staff gathered lots of information about our relatives likes and dislikes and made sure these were considered when decorating their room before they moved in’. Feedback from other agencies was also very positive about the homes procedures when admitting new people to the home. Information returned by the home stated that they would be looking at accessing independent advocacy services to further improve this process and to ensure that people are able to make real choices about where they live and the services they receive. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. 6,7,8,9. This judgement has been made using available evidence including a visit to this service. The home has a clear and consistent care planning process, which provides staff with the information they need to satisfactorily meet residents needs and enables the person using the service to make choices about their lifestyle and the care they receive. A variety of different and creative methods are used to help people who use the service to contribute in the development of their care plan and on-going review process. The service works creatively and actively with other services to ensure that the persons whole life needs are met, and goals addressed. EVIDENCE: The records of three residents were looked at in detail during the inspection. Where possible time was spent observing the care being provided to these Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 12 residents and discussion took place with their families and other agencies involved in their care. All of the residents who live at Deanbrook have very limited verbal communication and the staff spoken to said that written information about their needs is crucial to ensure that the care provided is consistent and delivered in a way that the person needs and prefers. The files inspected contained very detailed information about each resident. There were clear guidelines for staff about each persons preferred choice of support from when they wake up in the morning and throughout the day and night. All of the staff spoken to were able to give a clear account of this information and said that care records were easy to understand and accessible to those providing care. Records included short and long- term goals for each resident. There was information about their skills and support needs, and risk assessments, which recognised the need to enable people to partake in different experiences whilst keeping them as safe as possible. The format and content of this information confirmed that much consideration is given to the individuals’ rights, choice and personal preference. The staff work closely with each resident to put together their care plan details in a format that they are most likely to recognise and understand. One resident had this information displayed in picture frames in their bedroom, which included a range of diagrams, photos and symbols of people, places and events that are an important part of the individuals’ life. The manager said that this information would be used when reviewing and planning the individuals care arrangements. Staff demonstrated a good understanding of the different ways that people communicate. This information was clearly documented in residents’ files and staff had attended communication training and continue to work closely with the specialist speech and language services. An example was given about recent work undertaken to support a resident to move bedrooms within the home. A referral had been made to the Learning Disability service and advice was followed to put together a scrap- book of photographs of bedrooms, furniture and colour schemes to support the resident with this change. The manager said that this had worked well and ensured the resident experienced minimal anxiety and was fully involved in this change to their environment. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 11,12,13,14,15,16,17. This judgement has been made using available evidence including a visit to this service. The service has a strong commitment to enabling people to develop or maintain their skills, including social, emotional, communication and independent living skills. People who use the service are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capability, they have been involved in the planning of their lifestyle and quality of life. People using the service are able to enjoy a healthy and varied diet. Staff are sensitive to the needs of people who find it difficult to eat and give assistance when needed. EVIDENCE: Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 14 Resident’s records, care plans and other daily records included a range of information about opportunities for personal development, social and leisure opportunities. On the day of the inspection there was a warm and welcoming atmosphere in the home, some residents were enjoying a leisurely breakfast, others just starting to get up and some beginning to talk about the plans for the day with staff. Staff spoken to said that the home make good use of all the local facilities including shops, cafes, pubs and garden centres. A notice board in the main dining area included details of each resident’s activities for the week. The manager said that due to the age and complex care needs of residents these plans are flexible and may change to suit the needs of the individual each day. A key worker and activities- coordinator plan activities using information within the individuals care plan. Residents are involved by using a range of communication methods including photos, symbols and familiar objects. A weekly plan is then agreed and each activity is monitored and the outcome recorded so that this information can be used for future planning. The home has a very attractive and large garden, which all the residents enjoy during the summer months. There is a large activities shed, which has recently been used as an office facility during refurbishment. The manager said that now work in the home has been completed this would be again used for the residents activities during the day. On the day of the inspection some of the residents went out for lunch and to the garden centre to purchase fruit trees for the rear garden. Another resident had a plan to spend time with staff enjoying a hand manicure. One relative spoken to said that they are always pleased when they visit the home as residents are often out enjoying the good weather, ‘ On one occasion when we visited the staff took a resident out for several walks as this was what the resident seemed to be requesting’. Feedback from one staff member was that due to more recent staffing problems there are times when residents are not able to go out, and spend a lot of time around the house. One representative from a outside agency also commented that although they considered the home to provide an excellent standard of care ‘ there are times when all the ladies are in the house, when perhaps it would be beneficial for them to have more opportunities away from the home. Both these comments were discussed with the manager during the inspection. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 15 Records and discussion confirmed that residents are supported to maintain positive relationships with family and friends and these arrangements are documented and reviewed as part of the care plan process. Residents individual care plans had information and photographs of important people in their lives. One of the activity plans for a resident included quiet time with staff to look through their personal photo albums as a way of helping them settle into their new environment. A relative of one resident said that the staff always make them feel welcome when they visit and recognise and respond to any of their concerns or issues. Throughout the inspection staff spoke respectfully to residents and were sensitive and supportive when proving care. The way that records were written and the content of this information demonstrated that people’s rights, choices and privacy are considered when planning care. One family member commented that every time they visit they notice that the staff treat people with respect at all times. The inspector was able to join residents for lunch during the inspection. Residents were able to enjoy their meal within an attractive and comfortable environment. The meal- time was sociable, pleasant and unrushed. The food was laid out attractively so the residents could make choices and maintain their skills where possible. One of the residents needed a lot of support during the meal and staff were patient and sensitive to their needs. Records contained detailed information about any specific dietary requirements and examples were given of when the home had sought advice from a dietician to support one resident to maintain their skills when eating. Guidelines were being followed and special eating utensils had been purchased as recommended by the Dietician. Information provided by the home prior to the inspection stated that staff are trained in healthy eating and menus are planned with ‘ Five a day’ being at the forefront of nutritional needs whilst also taking into account peoples likes and dislikes. Residents were able to access the kitchen area with support from staff. Fresh fruit, snacks and drinks were offered to residents throughout the day. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. 18,19,20,21. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Staff members are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. EVIDENCE: Records were inspected, which evidenced good assessments and written information regarding peoples personal and healthcare needs. Guidelines were available for staff detailing each individual’s routines for the day and personal preferences about how care is delivered. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 17 ‘ Person Centred’ and ‘ Health Action’ plans confirmed that people are involved in planning their care and make decisions about their daily routines. All of the people that live at Deanbrook require a high level of support in all areas of personal care, and during the inspection all staff on duty were observed providing support and care in a sensitive and respectful manner. A visiting health professional said ‘staff are always respectful of residents and take the initiative to ensure that they can see the GP in private’. The manager said that routine health checks ensure that any health issues are addressed and a ‘ health appointment’ check list has been added to each file to ensure that these visits are up to date and not missed. Staff spoken to said that they use their knowledge of residents and a range of daily charts to monitor health, and address any changes as quickly as possible. Feedback from a representative from the Learning Disability service was very positive. Comments included; ‘ I am always very impressed, the staff have a good knowledge of residents needs even if they haven’t been directly involved with the individual, recording is excellent, staff demonstrate a good knowledge of Dementia, and have provided residents with excellent support during an admission to hospital’ The manager said that when a resident was recently admitted to hospital the staff put together a communication tool, which provided the individual with step by step information about what would happen and who would be their to support them. One of the specialist consultants involved in the residents’ admission praised the home for their support during this time. The home has clear and safe systems for recording, storing and administering medication. Each resident has a medication profile and this information is reviewed and updated as required. A senior member of staff was able to advice the inspector of the homes medication procedures and confirmed that all staff receive regular medication training. All records were found to be up to date and in good order. An example was given of how the home had recently supported residents using communication tools to make choices and have information regarding flu inoculations. Staff demonstrated a good understanding of changing needs due to illness and/ or the ageing process. Since the last inspection the residents and staff have experienced the sad death of a resident who had lived in the home for many years. The staff spoken to were very aware of how this may affect all those who had had a long relationship with this person. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 18 A request was made to the specialist learning disability service for Bereavement counselling and staff attended an in-house workshop with the lead Behavioural support team to enable them to support residents with the emotions relating to bereavement. A representative from the specialist learning disability service also commented that the staff in the home have recently demonstrated a good understanding of how to support people with care needs relating to the on-set of Dementia. Training records confirmed that staff attend training in this area of care. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 22,23. This judgement has been made using available evidence including a visit to this service. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. The complaints procedure is clearly displayed throughout the home and is given to family and other agencies involved in an individuals care. Policies and procedures regarding ‘ Safeguarding Adults’ are available to staff and give them clear guidance about what action should be taken. Due to recent ‘safeguarding’ issue all policies and procedures have been reviewed, which should further ensure the safety and protection of all people using the service. The manager is clear when an incident needs to be referred to the Local Authority as part of the local safeguarding procedures, and understands how to ensure that people living in the home remain safe. EVIDENCE: There have been no complaints made to the home or the Commission since the last inspection. The home had a written complaints procedure, which had been effectively simplified and converted into pictures and symbols. This was displayed in the communal dining area. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 20 The home has a small, consistent staff team who have a good awareness of the residents needs, and how each individual communicates. Staff spoken to said that this knowledge and understanding ensures that any concerns are understood and dealt with promptly. The key-worker system, daily recording, and health charts are used to monitor the well being of each individual. The manager advised that the home regularly liaises with the specialist speech and language services to improve the communication systems for each individual and to encourage choice and inclusion. Issues relating to the safety and protection of people who live in the home were looked at in detail during this inspection. The inspector looked at records and discussed this subject with the manager and three members of staff on duty. This information as well as being used within the inspection report will also be used as part of a recent government audit of ‘ safeguarding’ within care- homes. At the time of the inspection Social Services were in the process of dealing with a ‘ safeguarding’ issue in relation to one resident living at Deanbrook. The Registered Manager had been praised by the ‘ safeguarding ‘ coordinator for a prompt and professional response to the situation, ‘ Information provided by the manager was detailed and appropriate, which meant they could deal with the matter appropriately, whilst ensuring the on-going safety and protection of everyone living in the home’. All staff spoken to said that they had completed recent training in ‘ Adult protection’ were able to access the homes policies and procedures and were provided with relevant literature relating to this subject. The manager said that due to the recent ‘ safeguarding’ issue within the home the organisation had undertaken a full review of their policies and procedures. This would include looking at staff training, supervision, practice issues and recording. Staff would receive training and information about these changes as they begin to be implemented. The Registered manager has attended multi-agency and in-house training relating to ‘ Safeguarding’ procedures and safety of vulnerable adults. All residents require support to manage their finances and details of the support required was documented. Clear records were available for all incoming and out-going expenditure and these were found to be well maintained and up to date. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 24,25,26,27,28,29,30. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well- maintained and comfortable environment, which encourages their independence. The environment promotes the privacy, dignity and autonomy of the people who use the service. The bathrooms and toilets are fitted with appropriate aids and adaptations to meet the needs of the people who use the service, and are in sufficient numbers and are of good quality. EVIDENCE: A full tour of the premises was undertaken during the inspection. All parts of the home were found to be clean and well maintained. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 22 Since the last visit the home has been extended creating one new bedroom with en-suit facility. Changes have also been made to three of the original bedrooms. One room, which had previously been used for two residents’, has now been refurbished to create a single room with walk in shower. The staff office has moved into one of the smaller bedrooms, and this room has now been used to create a bedroom with improved facilities and space for a resident who has recently moved into the home. The manager said that they had consulted the learning disability team and speech/language department to ask for advice about how best to support residents during this time and to minimise any anxiety where possible. All of the bedrooms seen were attractively decorated with plenty of personal items and décor to suit individual tastes and needs. One family member said that they had been ‘ delighted’ when their relative moved into the home and the staff had decorated their room in their favourite colour scheme. Bedrooms and bathrooms contained a range of specialist equipment such as; electronically assisted beds, grabs rails, sensory equipment and a range of communication aids to meet the needs of individual residents. The manager said that the laundry has also been fitted with a sink for separate and safe hand washing and the communal sitting room has a new wide screen television so that all residents can enjoy good viewing. It was noted that the communal sitting room would benefit from some general decoration and the main seating in this room is in need of repair or renewal. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 31,32,33,34,35,36. This judgement has been made using available evidence including a visit to this service. Deanbrook has an experienced staff team who provide continuity of care to the people who use the service. The service has a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the service recognising the importance of this to ensure the protection of residents. EVIDENCE: The home has a small and well- experienced staff team. Some have worked in the home or for the organisation for many years and have a good understanding of the residents needs. All staff spoken to during the inspection were able to give a clear account of procedures in the home, their own role and the role of others. Ten staff surveys were completed and all said that they had received a good induction when they moved in to the home, had opportunities for training and felt well supported by the manager and other staff members. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 24 Most of the surveys completed stated that the care provided to residents could be improved with higher staffing levels. The manager said that there had been recent issues in the home that had resulted in reduced staffing levels. This was being addressed and efforts were being made to ensure consistency when using agency staff. The inspector spoke with an agency member of staff who was working in the home for the first time. She said she was very impressed with the information she had received about each resident, staff were very supportive and information was provided as part of a short induction about the homes procedures as well as important points relating to health and safety. A sample of staff records were seen, which confirmed that the home has a robust recruitment process, and structured induction programme. The manager said that all of the homes recruitment procedures were being reviewed due to recent ‘ safeguarding’ issues. The aim of the review was to ensure that people using the service are protected at all times. Records confirmed that all staff are registered to undertake relevant training relating to the home and the individual care needs of residents. Recent training had included; Communication, Bereavement Counselling and Safeguarding Adults. In addition to daily support and hand-over meetings staff receive 1:1 supervision every six to eight weeks. The manager did acknowledge that due to recent staffing problems these had not been taking place so frequently but that this had been identified as a priority issue that needed addressing. Staff spoken to said they felt well supported by their colleagues, management and senior staff within the organisation. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good. 37,38,39,41,42. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from an open, positive and inclusive style of management. Despite some recent staffing problems staff moral is generally good resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: Mrs Elizabeth Grills is the Registered Manager for Deanbrook and was present throughout the inspection. She has worked in the home for just over four years Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 26 and previously worked within senior management posts in other homes owned by the organisation. Mrs Grills has completed the Registered Managers award as well as an NVQ3 in mental Health, and NVQ4 in Management and Care. She also holds an NVQ Assessor qualification, certificate in advanced food hygiene and is currently undertaking a Diploma in Epilepsy. The manager had recently been commended by Social Services for her prompt and professional response to a situation concerning the safety and protection of a resident living at the home. Throughout the inspection there was a feeling of staff being open and supportive, and working closely as a team to ensure that residents needs are met. Comments within staff surveys included; ‘ The manager is very supportive, supervision and a thorough induction is available for all staff’, ‘ We have regular supervision and time is made available for discussion’. The home has a quality assurance system, which includes gathering regular feedback about the service from relatives, and other agencies. The manager said that this process was being reviewed with a view to improving the quality of information gathered and processes for feeding this information into an ongoing improvement plan for the home. Throughout the inspection a sample of records relating to the home and individual residents were inspected. These included; care plans, risk assessments, daily charts and monitoring forms, accident and incident reports and Fire records. All were found to be in good order, contained clear and relevant information and were up to date. Staff spoken to said that they were able to access the information they needed to meet residents daily care needs and were kept informed about any changes to policies and procedures within the home. Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 4 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 4 3 4 3 X 3 3 x Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 28 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations 2 YA24 Deanbrook DS0000003684.V362624.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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